My husband had a tooth removed a few days ago, and a piece of his jawbone came out with it. He was a bit freaked out when he saw the bone, but his dentist said this happens sometimes. Is this true?

Yes, it's true — pieces of bone that are very firmly attached to the root of the tooth can sometimes come out during the extraction. I have been in practice for 26 years, and this has happened on occasion. I hope the piece was small — it sounds as if the dentist was not alarmed when he removed the tooth, so I would say that this isn't anything to worry about; the bone will probably grow back. Of course, you can always ask your dentist about it again if you have any concerns or reservations.

Normally, in conventional extraction sockets, the bone grows back on its own once the tooth is removed. Growth can be enhanced by adding bone to the site at the time of the extraction. This is a routine procedure in which some type of sterilized synthetic bone or cow bone is incorporated into the blood clot forming a callus, or nidus, where future bone can form. In my practice, I routinely bone-graft every extraction I perform.

The doctor suggested not smoking for 10 days. Why is that suggested?
As we all know, smoking, in general, is bad for you. After the extraction of four wisdom teeth, there are sutures placed, bone often grafted in the sockets, large areas of swelling, and bleeding and blood clotting associated with the procedure.

There are a number of scientific reasons as to why smoking after a mouth operation is bad for you:

Smoking increases bone loss and therefore also reduces the amount of bone that is regenerated after surgical procedures like the removal of wisdom teeth.
The heat of smoke can affect your body's blood-clotting performance and can cause bleeding.
Cigarettes have 4,700 chemical compounds, including 60 known carcinogens. Post-op smoking is especially bad because these chemicals may cause periodontal disease, which causes bone loss and requires more surgery.
Smoking increases the risk of tooth loss after surgery.
Smoking causes a decrease in the body's inflammatory response, which affects the healing of wounds and the regeneration of bone and gingiva, the blood vessels surrounding your teeth.
Cigarettes decrease gingival blood flow. This also slows down the inflammation process, which heals the area and prevents infection.
After an operation as extensive as having all four wisdom teeth removed at once, it is critical to stay away from the heat, nicotine, and associated problems that cigarette smoking can cause.